What with all the pressure to make foods healthier, food manufacturers have been tweaking their products to reduce less healthful ingredients, especially salt and sugar.

Reformulated ultra-processed foods are still ultra-processed.

They raise the question: is a slightly healthier ultra-processed food a good choice?

These articles come from FoodNavigator-Asia.com, which tracks the food industry in that part of the world.

• Reformulating for the region: Coca-Cola, Nissin, Kirin and Hoow Foods weigh in on sugar, salt and fat reduction in APAC: Major brands across the region are continuing to double down on their reformulation efforts across sugar, salt and fat reduction after COVID-19 led to a rapid increase in consumer awareness and demand for healthier products. Read more
• Not so sweet situation: More than half of packaged beverages sold in Singapore contain high levels of sugar: Sixty per cent of packaged non-alcoholic beverages (NABs) sold on the Singapore market contain high amounts of sugar and would be assigned under Grade C or D in the soon-to-be-implemented Nutri-Grade system. Read more
• High pressure: Aussie retailers urged to prioritise sodium reformulation for private label products: Retailers in Australia should prioritise the sodium reformulation of private label products, which could help prevent over 500 deaths annually, according to a modelling study. Read more
• Encouraging reformulation: South Korea tightens food labelling standards for products with reduced sodium and sugar: South Korea has announced new, tighter standards for food firms looking to label their products as being reduced or lower in sodium or sugar, starting with the nation’s most-consumed food product, ramen. Read more

Healthy food? What’s that?

The FDA is working on a definition of “healthy” on food labels.

Blame KIND bars for all this.

The chronology of this saga.

2015: KIND puts the word “Healthy” on the labels of its whole-food bars.  FDA issues warning letter to KIND because its labels do not meet the requirements to make health claims.

2016: FDA reconsiders, says KIND can use “healthy.”   FDA issues request for information and comments on Guidance for Industry: Use of the Term “Healthy” in the Labeling of Human Food Products.

2017: FDA says it will reevaluate use of the term; holds public meeting on how to redefine the term “healthy” as a nutrient content claim.

2018: FDA’s Nutrition Innovation Strategy includes defining the term.

Healthy” is one claim that the FDA believes is ready for change, and we have already signaled our intention to update the criteria for this claim. The Agency is considering how to depict “healthy” on the package so that consumers can easily find it. Similarly, the FDA has also received requests for clarity on the use of “natural” in labeling. Just like other claims made on products regulated by FDA, we believe the “natural” claim must be true and based in science.

2019: The FDA proposes, and OMB approves, focus group review of a “healthy” icon on food packages.

As one of the methods for achieving this step of the Action Plan, the FDA is exploring the development of a graphic symbol to help consumers identify packaged food products that would meet an FDA definition for “healthy.” The symbol would be voluntary, allowing packaged food companies to place it on their products if the products meet the FDA definition of “healthy.”

2021: FDA again sends proposal to redefine “healthy to OMB, and announces further research on developing a ‘healthy” icon.

Nutrient Content Claims, Definition of Term: Healthy: The proposed rule would update the definition for the implied nutrient content claim “healthy,” and would revise the requirements for when the claim “healthy” can be voluntarily used in the labeling of human food products. In a separate but related action, on 7 May 2021 the FDA issued a notice in the Federal Register announcing that it is conducting preliminary quantitative consumer research on symbols that could be used in the future to convey the “healthy” claim on packaged foods.

The FDA has not said what definition it is considering.  I can think of three possible options:

• Nutrient-based: Below some level of sugar, salt, calories, or whatever
• Food-based: Must contain a fruit, vegetable, or whole grain
• Process-based: Must be unprocessed, processed, or minimally processed; cannot be ultra-processed

Anything other than process-based is too easy for food companies to game.

Center for Science in the Public Interest has plenty of concerns.

Allowing some products to carry a ‘healthy’ claim because they contain a minimal amount of a fruit, vegetable, or other recommended food would just make it easier for veggie chips and ‘fruit’ snacks to compete with fresh fruits and vegetables…No matter how FDA defines the term, consumers should realize that manufacturers will mostly be interested in using ‘healthy’ for marketing purposes—to sell you more processed food that you may not need.

The voluntary nature of the “healthy” symbol also raises questions.  If a food label does not use the symbol, how will anyone know if it’s not there because the product does not meet the definition of “healthy” or if its maker just chose not to use the symbol?

On “healthy,” whether word or symbol: stay tuned.

Leafy greens pose a seemingly intractable food safety problem.

• They are responsible for many harmful and deadly outbreaks of toxic E. coli (lawyer Bill Marler has a handy table listing outbreaks from 1995 to 2019).
• They are mostly eaten raw.
• They are often grown on land adjacent to dairy farms or cattle grazing or irrigated with water containing waste from animal agriculture.

The FDA is now taking on this last point.  It is is proposing standards for water use on produce for human consumption:  FDA.  Standards for the Growing, Harvesting, Packing, and Holding of Produce for Human Consumption Relating to Agricultural Water: Notice of proposed rulemaking.  The key provisions:

This proposal would replace the microbial criteria and testing requirements for pre-harvest agricultural water for covered produce (other than sprouts) with provisions for systems-based agricultural water assessments that are designed to be more feasible to implement across the wide variety of agricultural water systems, uses, and practices, while also being adaptable to future advancements in agricultural water quality science and achieving improved public health protections. Additionally, we are proposing to require
expedited mitigation for hazards related to certain activities associated with adjacent and nearby lands, in light of findings from several recent produce outbreak investigations.

Translation: Farms would have to assess where contamination of irrigation water might occur and take steps to prevent it, but will not have to test the water.

In its press release, the FDA says:

Today, the U.S. Food and Drug Administration issued a proposed rule that aims to enhance the safety of produce. It proposes to require farms to conduct comprehensive assessments that would help them identify and mitigate hazards in water used to grow produce. This is the latest step in the agency’s implementation of the FDA Food Safety Modernization Act (FSMA), and it proposes to replace some of the existing requirements for agricultural water in the Produce Safety Rule (PSR).

This updates the FDA’s previous attempts:

• Food Safety Modernization Act Proposed Rule on Agricultural Water
• Agricultural Water Assessment Fact Sheet  
• FSMA Final Rule on Produce Safety

Food safety lawyer Bill Marler asks: Is FDA creating a HACCP for Produce? Are assessment and mitigation going to create safer produce?

He notes that the FDA is focusing on “pre-harvest risk assessment of water risk as opposed to water testing for pathogens generally.”  This requires produce growers to evaluate local pathogen risks such as cattle operations and/or wild animal populations and then take measures to prevent them from contaminating water supplies.

But without having to test the water, it’s going to be hard to confirm that the assessment of risk actually reduces it.  Marler says:

So, in my view the jury is still out on 1) will eliminating water testing and increasing assessments make for a safer product? and, 2) should there not be a recognition that produce is essentially a “ready-to-eat” product grown outside with the risks inherent by what is directly around it or what may blow or flow to it, and therefore a broader environmental approach will be required to assure produce safety?

Is the FDA backing off of safety requirements?  The link explains how to file comments.  Now is the time to weigh in.

My thanks go to New Zealand reader Kirsten for sending this one.

The study: Exploring the Links between Diet and Inflammation: Dairy Foods as Case Studies. Julie M Hess, Charles B Stephensen, Mario Kratz, Bradley W Bolling.  Advances in Nutrition, Volume 12, Issue Supplement_1, October 2021, Pages 1S–13S,

Note: This article was intended as a review article based on presentations made by CBS, MK, and BWB at the American Society for Nutrition 2020 LIVE ONLINE Conference 7–10 June 2020.

Background: Systemic chronic inflammation may be a contributing factor to many noncommunicable diseases, including diabetes, cardiovascular disease, and obesity. An emerging body of evidence indicates that consuming certain foods, including dairy foods like milk, cheese, and yogurt, may be linked to a decreased risk for inflammation.

Method: Review of research on dairy foods and inflammation.

Conclusion: While there is currently insufficient evidence to prove an “anti-inflammatory” effect of dairy foods, the substantial body of clinical research discussed in this review indicates that dairy foods do not increase concentrations of biomarkers of chronic systemic inflammation.

Funding: The ASN Nutrition 2020 session that this article is based on was supported by the National Dairy Council. This support included honoraria for MK and BWB. The authors reported no funding received for this study.

Author disclosures: JMH was an employee of the National Dairy Council at the time this article was written. MK has received honoraria and reimbursements of travel costs as well as research funding from dairy-related organizations, including the National Dairy Council, Dairy Management, Inc., Dairy Farmers of Canada, the Dutch Dairy Organization (Nederlandse Zuivel Organisatie), Dairy Australia, and the French Dairy Interbranch Organization (CNIEL). BWB has received research funding for dairy-related projects from University of Wisconsin Dairy Innovation Hub, the National Dairy Council, and USDA National Institute of Food and Agriculture (NIFA) HATCH WIS02094. The other author reports no conflicts of interest.

Comment: This is a study by dairy-funded authors with an interesting spin.  The research review found no anti-inflammatory effect of dairy foods but concludes that they have a benefit: they don’t make inflammation worse.  I realize that dairy foods have a bad reputation among some eaters, but I wish the dairy industry didn’t sponsor research so blatantly in its self-interest.  I also wish we could get away from one-food research.  One food cannot possibly make a substantial difference in the diets of reasonably healthy people who eat a variety of foods.  I am all for eating dairy foods if you like them, especially from well-treated animals.  They have a place in healthful diets—or not ,if you don’t like or want to eat them.

Reference: For a summary of research on the “funding effect”—the observation that research sponsored by food companies almost invariably produces results favorable to the sponsor’s interests but that recipients of industry funding typically do not recognize its influence—see my book, Unsavory Truth: How Food Companies Skew the Science of What We Eat.

Melissa Fuster.  Caribeños at the Table: How Migration, Health, and Race Intersect in New York City.  University of North Carolina Press, 2021.

My former NYU colleague, Melissa Fuster, now at Tulane, has written a book length report on her research investigating the eating preferences of immigrants to New York from Puerto Rico, the Domincan Republic, and Cuba.

She used qualitative methods—interviews—to come to some reality-based conclusions about immigrant foodways.  She did not find deep longings for traditional Caribbean diets.  Instead, she also identified class, race, and gender as major influences on dietary preferences.

 Hence, with this work I aim to change ongoing scholarly conversations on the immigrant food experience and health outcomes in the United States, which tend to overemphasize the importance of culture when addressing immigrant communities.  This overemphasis on culture dimishes the role of the structural factors (class, race, gender) that intersect to shape the experiences of these communities, overstates the uniqueness of specific cultural groups, and risks blaming culture for the health inequities observed in these communities. (p. 5)

She has interesting things to say about how dietitians view the traditional diets of the Caribbean—as unhealthy and unsophisticated.

These racialized descriptions of comidas, including those made in nutri-speak [talking about foods strictly in terms of nutrient content]…are laden with meanings that reflect the cuisines roots in slavery and colonization—institutions that are built on oppression through racialization.  Despite the stigma attached to foods that emerged out of slave and colonial foodways, these foods traveled with their communities from the Caribbean to the United States.  (p. 96)

And she urges us to think about migrant eating patterns in the broader context of everyone’s eating patterns:

The prevalent focus on culture in the food and migration scholarship minimizes the struggles immigrants face in the home-making process and the political forces surrounding such processes…Moreover, this emphasis often carries an implicit assumption that traditional foods are  important for immigrant or ethnic communities, and that these foods are always healthier than the “new’ American foods.  We must also rethink this dichotomy.  All diets have a range of healthfulness, and in migration contexts, this depends on the interpretation of what traditional comidas are, and how frequently they are consumed.  As found in other studies, migrant communities engage in both healthful and unhealthful dietary practices upon moving.  (p. 128)

New items come out every day about the plant-based market for alternatives to meat and dairy foods.  Think of this as big business and hyper-marketing.

• By the numbers: Plant-based food sales and prices: In 2020, plant-based food retail sales grew 27% to be worth $7 billion, according to SPINS data released by the Good Food Institute and the Plant Based Foods Association. And even as consumers spent more money on groceries due to the pandemic, the plant-based segment grew at a faster clip than traditional products as a whole.
• Impossible Foods confirms plans for UK launch: The US brand, infamous for its meat-free burger that appears to ‘bleed’ like real meat, has confirmed plans to launch in Britain after applying for regulatory approval…. Read more
• Tracking the plant-based protein movement: Maple Leaf Foods’ Field Roast brand launches pea protein-based pepperoni at Whole Foods and Filipino brand UnMeat comes to a West Coast retail chain.5 ways to boost plant-based products in grocery stores: While there are many factors that play into plant-based product sales — including the category’s buzz, sustainability issues, animal welfare concerns, food allergies and the perception of a better health profile — retailers are an important link in the chain.. A study conducted by PBFA and Kroger between December 2019 and last February found that plant-based meat products sell 23% better when they’re in the meat section.
  Food flavour facility to explore sustainable plant-based foods:  The University of Nottingham has joined forces with the University of Adelaide to launch a new international food flavour facility to improve the taste of sustainable, healthy, plant-based food and ingredients. Read more
• Brits seek UK oat-drinks, but unaware of plant-based origins: Glebe Farms: A majority of Brits would prefer to buy plant-based milk from the UK, but many are unaware where their dairy alternatives are coming from, according to Glebe Farm Foods. Read more
• Quorn and Wibble Foods: Latest vegan launches: Meat alternatives firm Quorn and plant-based jelly pot manufacturer Wibble Foods revealed new vegan NPD this week. Read more
• Nestlé plant-based launches and cereal reformulation: Nestlé has boosted its vegan offering with the launch of plant-based egg and shrimp, as its reveals its latest progress toward reducing sugar in its cereal products. Read more
• Dairy… the next generation? General Mills unveils animal-free cream cheese alternative: Bold Cultr: General Mills has made a move into the emerging ‘animal-free’ dairy category with a brand called Bold Cultr – a lactose-free cream cheese alternative utilizing dairy proteins from Perfect Day made via microbial fermentation (without cows)…. Read more 
• Alt protein: Israeli start-ups innovate with grasshoppers, fermentation, and ‘plant made’ meatFrom ingredients to finished products, start-ups are innovating to produce the next hottest products in the alternative ingredient space. FoodNavigator hears from three making a splash in Israel’s food tech scene…. Read more

The US Agency for International Development (USAID) has issued two reports arguing that reduction of the prevalence of child stunting should no longer be used as the sole measure of success of nutrition intervention programs.

Background: Stunting is defined as low height-for-age.  It has long been used as a measure of nutritional deficiency due to inadequate diet in the presence of poor sanitation and other conditions.  Interventions focused on improving dietary intake rarely prevent stunting or affect it to only a small extent.

The first report: Stunting: Considerations for Use as an Indicator in Nutrition Projects

Emerging evidence supports the need to reexamine stunting as the primary indicatorof the success or failure of nutrition interventions.  Stunting should be interpreted not as an indicator of short-term programmatic success, but rather of the overall well-being of populations.  Not all nutrition programs, projects, or activities should be expected to reduce the prevalence of stunting… Failure to reduce the prevalence of stunting should not be interpreted as the failure of a nutrition program or project.  Nutrition programs should consider—and measure—a broader range of the many benefits that programs can achieve.

The second report:  Beyond Stunting: Complementary Indicators for Monitoring and Evaluating USAID Nutrition Activities

this guide shows how accurate and meaningful results, beyond stunting, can be captured through the use of more comprehensive and responsive indicators that directly link to an activity’s logical pathway…Measuring different types of indicators across the program’s impact pathway helps to understand how well programs are implemented and how results are achieved. Most important, measures like these allow for learning about what the program has, or has not achieved,
and why.

This second report provides a useful Table listing possible non-stunting indicators such as rates of breastfeeding, nutrient supplementation, home food production, participation in food assistance programs, and the like.

These are all downstream (personal) interventions.  I’d like to see USAID fund some more upstream (policy-based) interventions and see if those might do greater good for greater numbers of people.

I am indebted to Politico’s Helena Bottemiller Evich for her detailed analysis of the current status of attempts to keep toxic Salmonella out of meat and poultry.

Background

• Toxic Salmonella in meat and poultry sicken people who do not safely handle uncooked product.
• The meat industry argues that Salmonella are intrinsic to meat and poultry and, since the products are cooked and sterilized, Salmonella is not a problem requiring regulation.
• The FDA says the foods it regulates that are contaminated with Salmonella are subject to enforcement action.
• USDA has declared toxic forms of E. coli to be adulterants (and, therefore, illegal) in meat and poultry.
• In January, food safety lawyer Bill Marler petiotioned USDA to declare Salmonella an adulterant in meat and poultry (see story in the Washington Post)
• Also in January, CSPI and several other consumer groups sent USDA a similar petition.
• Marler has just visited Washington DC to push for immediate regulation and legislation.

Politico notes that his visit

comes on the heels of a scathing ProPublica investigation about multidrug-resistant Salmonella Infantis in poultry and our “baffling and largely toothless food safety system that is ill-equipped to protect consumers or rebuff industry influence.”

Marler is pushing hard on this issue.

• Hey Salmonella, put me out of business – Please
• Request to USDA for update on petition
• Did you know that USDA has a zero tolerance for Salmonella in beef served to school kids, but not for the rest of us?
• Let’s talk Turkey about Salmonella being an Adulterant

Everyone should be pushing hard on this issue.  It reveals two big food safety problems.

• The lack of coordination and consistency in food safety oversight by USDA (meat and poultry) and FDA (pretty much everything else).
• Capture of USDA by the meat industry, which relentlessly opposes stronger safety regulations.

The USDA’s response?

The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) today announced that it is…initiating several key activities to gather the data and information necessary to support future action and move closer to the national target of a 25% reduction in Salmonella illnesses…Despite consistent reductions in the occurrence of Salmonella in poultry products, more than 1 million consumer illnesses due to Salmonella occur annually, and it is estimated (PDF, 1.4 MB) that over 23% of those illnesses are due to consumption of chicken and turkey. “Reducing Salmonella infections attributable to poultry is one of the Department’s top priorities,” said USDA Deputy Under Secretary Sandra Eskin, who is leading the initiative.

The meat industry’s response?

The North American Meat Institute (Meat Institute) today welcomed the U.S. Department of Agriculture’s (USDA) new national goal of reducing Salmonella illnesses by 25 percent and committed to continue working with USDA and other groups to achieve the shared goal of reducing Salmonella infections…we will continue to work with USDA to do all we can to detect and deter incidents of Salmonellosis, especially by coordinating with partners in the supply chain on best practices and research.”

Will this work?  Stay tuned.